Written by Natalia Laspina
Medically reviewed by Maria Emilia Garralda (Gynecologist and Obstetrician, Expert in Sexual and Reproductive Health)
Art by Valentina Taraborelli

Starting an IVF journey means navigating both science and emotion. For many, it’s a path filled with hope, patience, and uncertainty—one that blends cutting-edge medicine with deeply personal dreams.

What Is IVF and How Does It Work?

In vitro fertilization (IVF) is an assisted reproduction treatment that enables conception outside the body. Eggs are retrieved and fertilized in a laboratory with sperm, and the resulting embryos are then transferred to the uterus. In the U.S., IVF accounts for nearly all assisted reproduction treatments. 

IVF generally follows four stages—preparation, ovarian stimulation, egg retrieval, and fertilization—closely aligned with the menstrual cycle. Throughout each stage, fertility specialists adjust medication and schedule follow-up visits based on ovarian response, hormonal levels (estradiol, progesterone, FSH, LH), and previous cycle history. This creates a feedback loop that helps guide every phase of the treatment.

Once the eggs are obtained, the next step is insemination. Depending on sperm quality, doctors may choose between conventional insemination or more advanced techniques like intracytoplasmic sperm injection (ICSI), where a single sperm cell is injected directly into the egg.

The resulting embryos are then cultured for a few days. If they develop properly, one or more embryos are transferred to the uterus of the intended parent or gestational carrier.

IVF Success Rates and Key Factors

The success rate of IVF is measurable but varies depending on factors such as age, underlying infertility causes, embryo quality, and the fertility clinic’s expertise.

One of the main factors behind IVF success is egg quality. Menstruating people under 35 have an average IVF success rate of 40% to 50% per cycle. This rate drops to about 30% to 35% for people aged 35–40, and to 10%–15% for those over 40. The anti-Müllerian hormone (AMH), along with FSH and antral follicle count, helps estimate reproductive capacity and set realistic expectations.

While these numbers can feel daunting, advances in technology and early intervention continue to improve success rates across all age groups.

Genetic Counseling in IVF: Why It Matters

As technology evolves, so does the need for emotional and educational support.

From the first experiments in animal fertilization in 1890 to the birth of Louise Brown in 1978, IVF has made extraordinary progress. In the past 25 years, major advances have included:

• Egg cryopreservation: The vitrification technique has enabled “freeze-all” cycles, separating stimulation from embryo transfer.
• Preimplantation genetic testing (PGT-A): Detects chromosomal abnormalities (aneuploidies), improving the safety and success of embryo transfers.
• Single-embryo transfer: Reduces the risk of multiple pregnancies.

Genetic counselors play a fundamental role throughout the IVF process. Interpreting genetic testing results can be overwhelming—this is where counseling makes a difference. 

According to a study published in the Journal of Assisted Reproduction and Genetics, 78.9% of patients found genetic education beneficial. Including these professionals as part of an interdisciplinary IVF support team helps patients interpret results and provides psychosocial guidance—ultimately improving their overall experience.

Age and Fertility: Understanding IVF Outcomes

Fertility in people with a uterus naturally declines with age due to the reduction in ovarian reserve and egg quality. The average age of first-time mothers continues to rise, and people with a uterus over 35 represent a growing group seeking IVF and other fertility treatments.

Open conversations about the limitations of assisted reproduction in advanced maternal age—and the associated risks for both mother and child—help individuals and couples stay informed and set realistic expectations before beginning a process that can be both emotionally and financially demanding.

This natural decline in fertility has two main causes: the decreasing number of eggs and the gradual reduction in their quality. The anti-Müllerian hormone, a glycoprotein secreted by the granulosa cells of ovarian follicles, peaks in a menstruating person’s early 20s and decreases steadily until menopause.

Because people with a uterus are born with a finite number of eggs, the ovarian reserve naturally declines over time, leading to fewer, lower-quality eggs and a higher risk of chromosomal abnormalities.

Preparing for an IVF Journey: Emotional and Financial Realities

Beyond medical procedures and statistics, IVF is a deeply personal experience. Studies exploring patient journeys in the U.S. highlight the most common emotional and practical challenges along the way:

• Cost and financial accessibility: Fertility treatments are often poorly covered by public health systems or insurance, leading to debt, financial stress, and difficult trade-offs with everyday expenses.
  
• Information overload and lack of clarity: Patients frequently receive large amounts of technical information—sometimes contradictory or confusing. Communication with professionals isn’t always empathetic or clear.
  
• Emotional impact: Frustration, anxiety, depression, guilt, or a sense of failure are common, along with physical and emotional exhaustion. Each failed cycle can feel like a small loss.
  
• Sex life and self-esteem: Difficulty maintaining sexual intimacy, loss of spontaneity, and negative body image.
  
• Relationship and social strain: Tension within couples, family pressure, social stigma, or isolation. In some cultures, infertility can lead to discrimination or self-exclusion.

Recognizing these emotional realities helps normalize the experience and reminds patients that support—both medical and emotional—is essential.

The Future of IVF: Technology, IA, and Access for All

Assisted reproduction has made remarkable progress in both efficiency and accessibility, but IVF still faces significant challenges—especially regarding global access and growing demand.

In 1999, over 63,000 IVF cycles were reported in the U.S., with a live birth rate of 29.4% per egg retrieval. At that time, transferring multiple embryos was common, leading to high rates of multiple pregnancies—about one-third were twins, and a small percentage were triplets or quadruplets.

Over the last two decades, numerous technological advances have transformed IVF practices: egg cryopreservation, “freeze-all” cycles, and preimplantation genetic testing for aneuploidies have all improved the safety and effectiveness of treatments.

Today, artificial intelligence is beginning to assist fertility specialists in ways that were once unimaginable. A recent study described an advanced AI model capable of predicting ovarian response and hormonal changes with remarkable accuracy. AI can help optimize medication dosages and timing for ovulation triggers, increasing treatment efficiency and easing specialists’ workloads. 

By standardizing certain clinical decisions, these tools can help make IVF more personalized, efficient, and—over time—more affordable.

Challenges Ahead

Looking forward, one key question is whether public health policies should expand preventive education—offering young adults guidance on both contraception and fertility under a shared framework of reproductive health for all genders.

Despite enormous technological and genetic progress, IVF remains financially and geographically inaccessible for many. Considering that infertility affects 17% of the global population—and factoring in cases such as recurrent miscarriages, fertility preservation for cancer patients, and reproductive needs of the LGBTQ+ community—demand still far exceeds availability.

The future of IVF largely depends on expanding access and standardizing procedures. Digitizing and automating the process could help improve outcomes while reducing costs.

Advances in artificial intelligence, genetic testing, and cryopreservation will continue to shape the future of assisted reproduction. Yet, democratizing access to IVF remains a global challenge. 

Consulting with fertility specialists is the first step toward exploring personalized options, making informed decisions, and overcoming economic, geographic, and social barriers.